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Musculoskeletal Science & Practice Aug 2020Although pelvic girdle pain postpartum and pregnancy related low back pain postpartum (combined and named PGPP in this study) have a natural favourable course, there is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although pelvic girdle pain postpartum and pregnancy related low back pain postpartum (combined and named PGPP in this study) have a natural favourable course, there is a subgroup of women who have persistent complaints. The objective of this study was to identify personal-, (pre)pregnancy-, obstetric-, and child related risk factors on PGPP by means of a systematic literature review and meta-analysis.
METHODS
Literature searches of PubMed, EMBASE, CINAHL and Cochrane up to October 2018 were conducted. Prospective cohort studies in English or Dutch describing three or more risk factors for PGPP were included. We assessed articles for inclusion and risk of bias. Studies with high risk of bias were excluded from data extraction. Data was extracted and checked for accuracy confirming to the CHARMS-checklist. Homogeneous variables were pooled.
RESULTS
Twelve full text studies were assessed. Seven studies were excluded due to high risk of bias. Data was extracted from five studies. Multivariate analysis was not possible due to heterogeneity in included risk factors as well as outcome measures on risk factor per study. Pooled univariate significant risk factors on PGPP were: a history of low back pain, pre-pregnancy body mass index >25, pelvic girdle pain in pregnancy, depression in pregnancy, and a heavy workload in pregnancy. No significant obstetric and child related risk factors were reported.
CONCLUSIONS
Risk factors on PGPP have been identified. Since multivariate analysis was not possible the outcome should be treated with care, because interaction between risk factors could not be analysed.
Topics: Child; Female; Humans; Low Back Pain; Pelvic Girdle Pain; Postpartum Period; Pregnancy; Pregnancy Complications; Prospective Studies; Risk Factors
PubMed: 32560862
DOI: 10.1016/j.msksp.2020.102154 -
Sleep Medicine Reviews Aug 2019Sleep is essential for children's health and well-being. Characteristics of children's sleep such as sleep duration, timing, quality and variability are increasingly...
Sleep is essential for children's health and well-being. Characteristics of children's sleep such as sleep duration, timing, quality and variability are increasingly being associated with a wide range of health outcomes. The purpose of this study is to conduct a meta-review (systematic review of systematic reviews) to examine the relationship between sleep and health in children. A systematic search of four electronic databases (Medline, PsychInfo, Scopus, and Embase) was conducted to identify systematic reviews that examine the association between characteristics of children's sleep and health. Key findings, as well as areas in need of further research were synthesised descriptively. A total of 39 systematic reviews were identified for inclusion, covering areas of cognition, psychosocial health, cardiometabolic health, adiposity and other outcomes such as musculoskeletal pain. There is substantial and consistent evidence relating sleep duration to adiposity and emotional outcomes. The relationships between sleep quality and timing and blood lipids and glycaemic control merit further research. Links between sleep and metabolic syndrome in children appear to be weak and inconsistent. Key areas identified in need for further research included studies that objectively assess children's sleep and move beyond cross-sectional study designs and consider characteristics of sleep other than duration. It was also noted that covariates applied across studies varied considerably and the issue of residual confounding was raised in a number of reviews. Lastly, all reviews reported studies adopted a traditional approach of examining only one aspect of children's sleep. Systematic reviews support the notion that sleep is important for children's health. However, further studies that objectively assess sleep and consider characteristics of sleep other than duration and outcomes other than adiposity are needed. An understanding of sleep as a multidimensional construct and as a component of the 24-h d, is also needed to better understand the relationship between sleep and health in children.
Topics: Adiposity; Child; Cognition; Health Status; Humans; Metabolic Syndrome; Review Literature as Topic; Sleep
PubMed: 31121414
DOI: 10.1016/j.smrv.2019.04.011 -
The Journal of Orthopaedic and Sports... Sep 2023We aimed to estimate the benefits and harms of cervical spinal manipulative therapy (SMT) for treating neck pain. Intervention systematic review with meta-analysis of... (Meta-Analysis)
Meta-Analysis Review
We aimed to estimate the benefits and harms of cervical spinal manipulative therapy (SMT) for treating neck pain. Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). We searched the MEDLINE, Cochrane CENTRAL, Embase, CINAHL, PEDro, Chiropractic Literature Index bibliographic databases, and grey literature sources, up to June 6, 2022. RCTs evaluating SMT compared to guideline-recommended and nonrecommended interventions, sham SMT, and no intervention for adults with neck pain were eligible for our systematic review. Prespecified outcomes included pain, range of motion, disability, health-related quality of life. Random-effects meta-analysis for clinically homogenous RCTs at short-term and long-term outcomes. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 Tool. We used the Grading of Recommendations, Assessment, Development, and Evaluations approach to judge the certainty of evidence. We included 28 RCTs. There was very low to low certainty evidence that SMT was more effective than recommended interventions for improving pain at short term (standardized mean difference [SMD], 0.66; 95% confidence interval [CI]: 0.35, 0.97) and long term (SMD, 0.73; 95% CI: 0.31, 1.16), and for reducing disability at short-term (SMD, 0.95; 95% CI: 0.48, 1.42) and long term (SMD, 0.65; 95% CI: 0.23, 1.06). Transient side effects only were found (eg, muscle soreness). There was very low certainty evidence supporting cervical SMT as an intervention to reduce pain and improve disability in people with neck pain. .
Topics: Adult; Humans; Neck Pain; Manipulation, Spinal; Bias
PubMed: 37561605
DOI: 10.2519/jospt.2023.11708 -
Journal of Bodywork and Movement... Oct 2022Therapeutic taping may be a useful modality in relieving pain, improving strength, and restoring the function of patients with De Quervain's Disease (DQD). Evidence on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Therapeutic taping may be a useful modality in relieving pain, improving strength, and restoring the function of patients with De Quervain's Disease (DQD). Evidence on the effectiveness of therapeutic taping for DQD patients in mitigating its clinical signs and symptoms is not established. However, reviews report Kinesio Taping effects on musculoskeletal pains not specific to DQD.
METHODS
The study followed the guideline statement of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two researchers (RD and SN) searched the electronic databases and hand-searched for relevant journals. The relevant articles were selected using keywords found in titles and abstracts and, consequently, full-text manuscripts. A third researcher (VCDIII) resolved the disagreements between the two researchers. They used Review Manager 5.4 for risk of bias assessment and meta-analysis. Data were pooled to determine the therapeutic taping's overall effect. Heterogeneity was assessed by Higgin's (I) statistic. The random-effects model was used if heterogeneity was high (>60%). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Approach determined the certainty of evidence.
RESULTS
Seven high-risk of bias clinical-controlled trials comprising 241 participants were included in the meta-analysis. The reported outcome measures were the Visual Analogue Scale (VAS) for pain, Patient-Rated Wrist/Hand Examination for Function and Power, and precision grip strength using a hand-held dynamometer and pinch gauge. Therapeutic taping did not improve the pain, power grip, grip strength, and function of participants with DQD (p > 0.05). Therapeutic taping compared to other physical therapy interventions did not reduce the VAS scores of 241 participants with DQD [SMD (95% CI) = -1.08 (-2.55,0.39), p = 0.15]. Kinesio taping with low-level laser therapy compared to ultrasound and exercise did not improve the function of 60 participants with DQD [SMD (95% CI) = 0.56 (-4.71,3.60), p = 0.79]. Therapeutic taping compared to ultrasound and Mulligan Pain Releasing Phenomenon did not improve the power grip strength of 50 participants with DQD [SMD (95% CI) = 1.24 (-0.83,3.31), p = 0.24]. Therapeutic taping was not better than phonophoresis in improving the precision grip strength of 50 participants with DQD [SMD (95% CI) = 0.43 (-1.95,2.80), p = 0.72].
CONCLUSIONS
There is insufficient evidence to recommend the use of therapeutic taping in treating patients with DQD. Therapeutic taping was no better than other treatment modalities in mitigating the clinical signs and symptoms of DQD (p > 0.05). Therapeutic taping did not affect wrist pain, handgrip, pincer strength, and function of participants with DQD (p > 0.05).
Topics: Athletic Tape; De Quervain Disease; Hand Strength; Humans; Musculoskeletal Pain; Pain Measurement
PubMed: 36180153
DOI: 10.1016/j.jbmt.2022.05.004 -
Pain Jan 2022Exercise and pain neuroscience education (PNE) have both been used as standalone treatments for chronic musculoskeletal pain. The evidence supporting PNE as an adjunct... (Meta-Analysis)
Meta-Analysis
Exercise and pain neuroscience education (PNE) have both been used as standalone treatments for chronic musculoskeletal pain. The evidence supporting PNE as an adjunct to exercise therapy is growing but remains unclear. The aim of this systematic review and meta-analysis was to evaluate the effect of combining PNE and exercise for patients with chronic musculoskeletal pain, when compared with exercise alone. A systematic search of electronic databases was conducted from inception to November 6, 2020. A quality effects model was used to meta-analyze outcomes where possible. Five high-quality randomized controlled studies (n = 460) were included in this review. The PEDro scale was used to assess the quality of individual studies, and Grading of Recommendations, Assessment, Development, and Evaluation analysis was conducted to determine the quality of evidence for each outcome. Meta-analyses were performed for pain intensity, disability, kinesiophobia, and pain catastrophizing using data reported between 0 and 12 weeks postintervention. Long-term outcomes (>12 weeks) were only available for 2 studies and therefore were not suitable for meta-analysis. Meta-analysis revealed a significant difference in pain (weighted mean differences, -2.09/10; 95% confidence interval [CI], -3.38 to -0.80; low certainty), disability (standardized mean difference, -0.68; 95% CI, -1.17 to -0.20; low certainty), kinesiophobia (standardized mean difference, -1.20; CI, -1.84 to -0.57; moderate certainty), and pain catastrophizing (weighted mean differences, -7.72; 95% CI, -12.26 to -3.18; very low certainty) that favoured the combination of PNE and exercise. These findings suggest that combining PNE and exercise in the management of chronic musculoskeletal pain results in greater short-term improvements in pain, disability, kinesiophobia, and pain catastrophizing relative to exercise alone.
Topics: Catastrophization; Chronic Pain; Exercise; Exercise Therapy; Humans; Musculoskeletal Pain
PubMed: 33863860
DOI: 10.1097/j.pain.0000000000002308 -
Physiotherapy Mar 2023Low back (LBP) and pelvic girdle pain (PGP) during pregnancy are related to high direct and indirect costs. It is important to clarify evidence regarding interventions... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Low back (LBP) and pelvic girdle pain (PGP) during pregnancy are related to high direct and indirect costs. It is important to clarify evidence regarding interventions to manage and prevent these conditions.
OBJECTIVE
Investigate the efficacy and acceptability of the interventions to prevent LBP and PGP during pregnancy.
DATA SOURCES
Searches were conducted up to January 6th, 2021 in the MEDLINE, PEDro, Cochrane Library, SPORTDiscus, CINAHL, AMED, Embase and PsycInfo databases STUDY ELIGIBILITY CRITERIA: (1) Pregnant women without LBP and/or PGP; (2) any prevention strategy on incidence of LBP and PGP and sick leave; (3) comparison to control; (4) quasi and randomised controlled trial.
STUDY APPRAISAL AND SYNTHESIS METHODS
Two reviewers performed screening, data extraction and methodological quality assessments. Meta-analysis was performed and Relative Risks (RRs) and 95% confidence intervals (CIs) were reported.
RESULTS
Six randomised controlled trials involving 2231 participants were included in the review. Evidence of moderate quality was found that "stand-alone" exercise is acceptable to pregnant women with lumbopelvic pain (LBPP) (RR 0.60 [95%CI 0.42-0.84]) and prevents episodes of LBP (RR 0.92 [95%CI 0.85-0.99]) in the long-term. Moderate to very-low quality evidence was found detailing the lack of efficacy of other interventions in the prevention of these problems in the short and long-term.
LIMITATIONS
Small number of trials included.
CONCLUSIONS
Efficacy of prevention strategies for episodes of LBPP and the use of sick leave during pregnancy is not supported by evidence of high quality. Current evidence suggests that exercise is acceptable and promising for the prevention of LBP in the long-term. However, further high-quality trials with larger samples are needed. CONTRIBUTION ON PAPER.
Topics: Female; Pregnancy; Humans; Pelvic Girdle Pain; Low Back Pain; Exercise; Exercise Therapy; Sick Leave; Randomized Controlled Trials as Topic
PubMed: 36288631
DOI: 10.1016/j.physio.2022.09.004 -
Journal of Pain Research 2023Fibromyalgia (FM) is a chronic pain sensitivity syndrome characterized by diffuse musculoskeletal pain and many other systemic manifestations. Low-dose naltrexone (LDN)... (Review)
Review
Fibromyalgia (FM) is a chronic pain sensitivity syndrome characterized by diffuse musculoskeletal pain and many other systemic manifestations. Low-dose naltrexone (LDN) has been increasingly used as an off-label treatment option in FM. However, current evidence on the safety and efficacy of LDN in patients with FM is not well known. To systematically assess the current evidence on the safety and efficacy of LDN use in the treatment of FM. A comprehensive bibliographic search was conducted on EBM Reviews - Cochrane Central Register of Controlled Trials, EBM Reviews - Cochrane Database of Systematic, Embase, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions and Scopus databases in September 2022. Inclusion criteria were articles that were published in English, focusing on clinical trials involving LDN for the treatment of FM. Two reviewers independently screened and extracted the data. A qualitative analysis was used due to the high methodological heterogeneity between studies. The electronic search produced 805 articles. After applying the inclusion criteria, 9 articles (one RCT, two case reports, two case series, and four pilot trials) were selected for evaluation. LDN intervention protocols, study designs, and follow-up periods were different among the included studies. Overall, LDN was found to be effective in the symptomatic management of FM, and of the 78% of included studies that evaluated for safety, no severe adverse events were reported. Proving the efficacy and safety of low-dose naltrexone is a future possibility based on current study data, but the level of scientific evidence is limited. Future well-designed trials with large sample sizes are required.
PubMed: 36974308
DOI: 10.2147/JPR.S395457 -
International Journal of Environmental... May 2022Food strategies are currently used to improve inflammation and oxidative stress conditions in chronic pain which contributes to a better quality of life for patients....
The Effectiveness of Intermittent Fasting, Time Restricted Feeding, Caloric Restriction, a Ketogenic Diet and the Mediterranean Diet as Part of the Treatment Plan to Improve Health and Chronic Musculoskeletal Pain: A Systematic Review.
Food strategies are currently used to improve inflammation and oxidative stress conditions in chronic pain which contributes to a better quality of life for patients. The main purpose of this systematic review is to analyze the effectiveness of different dietary strategies as part of the treatment plan for patients suffering from chronic pain and decreased health. PubMed, Web of Science, ProQuest, Scopus, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Cambridge Core, and Oxford Academy databases were used to review and to appraise the literature. Randomized clinical trials (RCT), observational studies, and systematic reviews published within the last 6 years were included. The Physiotherapy Evidence Database (PEDro) scale, the PEDro Internal Validity (PVI), the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a variety of fields (QUALSYT), and the Quality Assessment Tool of Systematic Reviews scale were used to evaluate the risk of bias of the included studies. A total of 16 articles were included, of which 11 were RCTs and 5 were observational studies. Six of them showed an improvement in pain assessment, while two studies showed the opposite. Inflammation was shown to be decreased in four studies, while one did not show a decrease. The quality of life was shown to have improved in five studies. All of the selected studies obtained good methodological quality in their assessment scales. In the PVI, one RCT showed good internal validity, five RCTs showed moderate internal quality, while five of them were limited. Current research shows that consensus on the effects of an IF diet on pain improvement, in either the short or the long term, is lacking. A caloric restriction diet may be a good long term treatment option for people suffering from pain. Time restricted food and ketogenic diets may improve the quality of life in chronic conditions. However, more studies analyzing the effects of different nutritional strategies, not only in isolation but in combination with other therapies in the short and the long term, are needed.
Topics: Caloric Restriction; Chronic Pain; Diet, Ketogenic; Diet, Mediterranean; Fasting; Humans; Inflammation; Musculoskeletal Pain
PubMed: 35682282
DOI: 10.3390/ijerph19116698 -
International Journal of Environmental... Oct 2022The Feldenkrais Method (FM) is based on the learning of alternative movement patterns, carried out in an active and conscious way, which may have therapeutic effects.... (Meta-Analysis)
Meta-Analysis Review
The Feldenkrais Method (FM) is based on the learning of alternative movement patterns, carried out in an active and conscious way, which may have therapeutic effects. The objective of this systematic review is to identify the populations and conditions for which the FM can be used in physiotherapy and to determine the intervention modalities. Research in PubMed, Cochrane and PEDro databases was performed. The PEDro scale was employed to assess the methodological quality. Meta-analyses (MA) were performed whenever populations and outcome measures were comparable in at least two studies. Sixteen studies were included. In elderly people, in three of the four selected trials, the FM group significantly improved gait, balance, mobility and quality of life. The MA showed significant differences between interventions in the Timed-Up-and-Go test [Cohen's d = -1.14, 95% CI (-1.78, -0.49), = 0.0006]. FM significantly improved pain, functional balance, and perceived exertion in three trials performed on subjects with cervical, dorsal, or shoulder pain. FM demonstrated improvements in pain, disability, quality of life and interoceptive awareness in the three trials performed in subjects with chronic low back pain. In multiple sclerosis, an improvement in functional capacity was observed in the two selected studies. The MA showed no significant differences between groups in the Function ( = 0.97) and Control ( = 0.82) dimensions of the Multiple Sclerosis Self-Efficacy Scale. In Parkinson's disease, two studies showed significant effects on quality of life and functional tests. In conclusion, evidence shows that FM has therapeutic effects comparable to other physiotherapy techniques in patients with spine pain. In addition, improvements in mobility and balance were seen in the elderly and people with neurodegenerative diseases.
Topics: Humans; Aged; Postural Balance; Quality of Life; Time and Motion Studies; Randomized Controlled Trials as Topic; Physical Therapy Modalities; Low Back Pain; Multiple Sclerosis
PubMed: 36360614
DOI: 10.3390/ijerph192113734 -
Journal of Neurology Apr 2020Rhabdomyolysis (RML) is an interdisciplinary condition due to muscle cell injury followed by the release of cell components into circulation. Etiology of RML has a broad...
BACKGROUND
Rhabdomyolysis (RML) is an interdisciplinary condition due to muscle cell injury followed by the release of cell components into circulation. Etiology of RML has a broad range; a serious complication is acute kidney injury (AKI). Despite its high relevance, there is no established formal definition for RML.
OBJECTIVES
A systematic review, focusing on RML definition, providing a recommendation for clinicians.
METHOD
Systematic literature research in PubMed and Embase (1968-07/2018).
RESULTS
The database research presented 8136 articles in PubMed and 2151 in Embase. After screening, 614 papers were retained for statistical analysis. A retrospective study was the most used design (44%). A definition of RML was stated in 231 studies (37.6%), including a precise creatine kinase level (CK) cut-off most frequently (67.1%). In 53/231 (22.9%) studies the CK cut-off was > 5 × upper limit of normal (ULN), and in 64/231 (27.7%) studies > 1000 IU/L. Further components of definitions were elevated CK without specific thresholds, and clinical symptoms. Exclusion criteria referring to the definition of RML were established in 113 studies, including myocardial, renal, cerebral and neuromuscular characteristics.
CONCLUSION
At present, we recommend a clinical syndrome of acute muscle weakness, myalgia, and muscle swelling combined with a CK cut-off value of > 1000 IU/L/ or CK > 5 × ULN for the standard definition of a mild RML. Additionally measured myoglobinuria and AKI indicate a severe type of RML. Exclusion criteria as well as the chronological sequence need to be considered for a conclusive RML definition.
Topics: Acute Kidney Injury; Creatine Kinase; Humans; Muscle Weakness; Myalgia; Rhabdomyolysis; Syndrome
PubMed: 30617905
DOI: 10.1007/s00415-019-09185-4